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Medical Forum / Diseases and Disorders / Diabetes / March 2006OCT & retinal exam today: mostly good news.
I had my second recent OCT scan and retinal exam today, plus a long chat with the Ophthalmologist. In brief, my retinopathy seems to be receding quickly. The left eye shows a great deal of improvement, as do many areas of my right. The bad news is that one of the edemas is worse, and will require laser surgery. I'll be having it done on Tuesday. However, all in all I'm very happy with the results. Now, about my talk with the Ophthalmologist: He confirmed my belief that my retinopathy is most likely transient (temporary). HOWEVER, he does not believe that applies to the edemas they can cause. Those need treating once past a certain point, as at least one of mine is. As for what caused this (and thus important for newbies) he did confirm that in his opinion, the rapid decrease in my BG's was causal. HOWEVER, he feels that I'm "much better off in the long run". He said the main danger is if a condition like mine was left untreated UNTIL VISUAL PROBLEMS BECOME APPARENT. The reason is that once visual changes occur in a case like mine, they are most likely irreversible. So, he pointed out that I'm lucky I went in when I did. This tells me, loud and clear, that getting a newbie in for an exam is critical, because in many cases once symptoms occur some irreversible damage has likely been done. He most strongly recommends getting an exam within a few weeks of DX. (So, yes, I'll be continuing to post my warnings to newbies.) Regarding blood sugars: He also said there are many schools of thought as to whether a slower decline would lessen or avoid normoglycemic re-entry phenomenon. He said he does not know the answer to that one. I also asked him for specifics regarding HBA1C target levels. He said under 6 is the ideal goal, as eye damage and degradation becomes far more likly and severe as blood glucose levels increase. He also said that there are recommendations out there that say 7% is ok, but he said he doubted I'd find an ophthalmologist who thinks that. OK, no major surprises so far, but here comes a doozy: I asked him for target HB1AC's for me, personally. He remembered that I was at 5.4 after Dx. He took a look at my BG logs for that week (the week I had the test) and my one for last week. He said that most likely my A1C was already lower, and guessed around 5.0. (that was my guess, too). I mentioned that I'd been keeping my BG's up a little (90's between meals, by snacking on apricots) and he said that couldn't hurt in my case, but he wouldn't advise anyone with higher BG's to try that. I asked about lowering my BG's further, (and here comes the shock) he said he wouldn't advise it! At least not until my retinas are stable. He also said he didn't see much point in even trying, even once I was stable. My opinion is I'll leave things as they are for at least a year, and see where things stand. He didn't say so directly, but I think he was indicating that a BG change right now (in either direction) could have a negative impact. My current BG limits are under 120 at one hour, under 100 at two hours, between 80 and 90 between meals. Without the fruit snacks I've been having, my between meal bg's are in the low 70's. I'm going to ask my new GP (as soon as I find one) about reducing my metformin dose so I don't need to snack to keep the between meal BG's up. A note to newbies reading this: Please don't let my numbers bother you. I mention them here only because it's relevant, but it needs to be pointed out that apparently my diabetes (T2) is a bit atypical, so I have an easier time with BG numbers than many others do. So, all in all, a very interesting day, and one I'm personally very happy with. The fact that the retinopathy seems to be reversing delights me, as I was very concerned that it's previous rapid progression would continue. > I had my second recent OCT scan and retinal exam today, plus a long > chat with the Ophthalmologist. [quoted text clipped - 72 lines] > delights me, as I was very concerned that it's previous rapid > progression would continue. Hello, Chris J This almost all sounds great to me. I hope the surgery is a success. I'm sure it will go fine; your doc sounds like he is pretty capable to me. But I wish you the best possible result with that. Did you happen to ask him about the insulin tie-in? That sounds like it might be involved from what you have learned. I'm sure your doc thought that normal bg is good enough, and you are operating in normal ranges these days. And you are probably correct that he wants you to be stable. I expect he'll want to monitor your eyes pretty closely for a while to make sure things are not getting worse. This is looking like it might be ok, which, I hope you know, would be a tremendous relief because I know how worried about it I am, and I know the rest of the group is surely just as concerned. Very good news. best wishes, rudy bantista@thuntek.net T2, last A1c 5.9, current bg 119 >Hello, Chris J > >This almost all sounds great to me. I hope the surgery is a success. I'm >sure it will go fine; your doc sounds like he is pretty capable to me. But I >wish you the best possible result with that. Did you happen to ask him about >the insulin tie-in? Yes, but, he suggested I ask the retinal specialist about that. I'll do so Tuesday if I can, and if not shortly thereafter. It's something I'm very eager to find out. >That sounds like it might be involved from what you >have learned. From what I've seen so far, it at the very least makes it far more likely. >I'm sure your doc thought that normal bg is good enough, and >you are operating in normal ranges these days. And you are probably correct >that he wants you to be stable. I'm ok with that, as long as he means my Bg's and not my mental state. <Grin> >I expect he'll want to monitor your eyes >pretty closely for a while to make sure things are not getting worse. This >is looking like it might be ok, which, I hope you know, would be a >tremendous relief because I know how worried about it I am, and I know the >rest of the group is surely just as concerned. Thanks, Rudy! BTW, more good news! SNOW! It's so badly needed here, and it's falling now. I hope you get some precip too. Hopefully by the time you see this you will be. <snipped for brevity - but read it all> >In brief, my retinopathy seems to be receding quickly. The left eye >shows a great deal of improvement, as do many areas of my right. > >The bad news is that one of the edemas is worse, and will require >laser surgery. I'll be having it done on Tuesday. Wonderful news about the retinopathy Chris, and I'll be thinking of you on Monday (Australians are ahead of the rest of the World - apart from Quentin). Thanks for all the detail. Some thought-provoking points there. On your comment on newbies, try not to scare them too much. I'd suggest a general advice to see the standard specialists - eyes, feet, heart - but watch for newbies who seem to go gung ho - like one I could name who lives in high-altitude bear country. Cheers, Alan, T2, Australia. d&e, metformin 2x500mg  SignatureEverything in Moderation - Except Laughter. > I'd suggest a general advice to see the standard specialists > - eyes, feet, heart - but watch for newbies who seem to go > gung ho - like one I could name who lives in high-altitude > bear country. I thought it was beer country? ;) : > I'd suggest a general advice to see the standard : specialists : > - eyes, feet, heart - but watch for newbies who seem to go : > gung ho - like one I could name who lives in high-altitude : > bear country. : I thought it was beer country? ;) No, that's where you and Alan live:-) Wendy Hi Wendy: > : > I'd suggest a general advice to see the standard > : specialists [quoted text clipped - 5 lines] > > No, that's where you and Alan live:-) Coors is not that far away. ;) From the land of sky blue waters! Frank ><snipped for brevity - but read it all> > [quoted text clipped - 7 lines] >thinking of you on Monday (Australians are ahead of the rest >of the World - apart from Quentin). Hmmmm... Australians may be way ahead, but perhaps not when it comes to reading calendars! Maybe it's because your ca lander is upside down? Tuesday my time is Wednesday, not Monday, your time. <grin> (sorry, couldn't resist!) :-) :-) :-) :-) >Thanks for all the detail. Some thought-provoking points >there. > >On your comment on newbies, try not to scare them too much. >I'd suggest a general advice to see the standard specialists >- eyes, feet, heart - I agree about that. Dx is scary enough. I do however think a specific mention of normoglycemic re-entry phenomenon might be in order, as many Docs advise waiting on the eye exam (and this is a good reason not to). Insulin may be an issue, so I'd be inclined to give stronger warnings to newbies who have initial insulin treatment similar to my own. >but watch for newbies who seem to go >gung ho - like one I could name who lives in high-altitude >bear country. ROFL!! <snip> >>Wonderful news about the retinopathy Chris, and I'll be >>thinking of you on Monday (Australians are ahead of the rest [quoted text clipped - 5 lines] >Tuesday my time is Wednesday, not Monday, your time. <grin> >(sorry, couldn't resist!) :-) :-) :-) :-) You're right - it's my backwards thinking:-) Just for interest, as I write this it is 23:43, or 11:43 pm Saturday night, 11th March. In NYC it is 07:43 on Saturday, in London it is 43 minutes past noon and in Albuquerque it is 05:43. In a little over half an hour it will be Sunday here - but it will still be Saturday over there:-) The date-line is just east of Fiji. When we flew to California it was a long journey. An hour's cab-ride, another hour at the airport, an hour's flight to Sydney, several hours in the terminal between flights and thirteen more hours in the air. We arrived in LA 25 minutes before we stepped out of our front door on the same day. So - good luck on Wednesday:-) Cheers, Alan, T2, Australia. d&e, metformin 2x500mg SignatureEverything in Moderation - Except Laughter. ><snip> >>>Wonderful news about the retinopathy Chris, and I'll be [quoted text clipped - 16 lines] >half an hour it will be Sunday here - but it will still be >Saturday over there:-) Yes, very strange indeed. Almost as strange as your notorious penchant for celebrating New Year's in Summer. :-) >The date-line is just east of Fiji. When we flew to >California it was a long journey. An hour's cab-ride, >another hour at the airport, an hour's flight to Sydney, >several hours in the terminal between flights and thirteen >more hours in the air. I've crossed the date line both by air and sea. By air, the first time, it was from Tahiti to Fiji. On the way back it was by sea (I was going from Sydney to the UK by sea, via the pacific, panama canal, and Atlantic). By sea was interesting. The ship's menus had the day and date on them. So, they had Sunday, June 11th, #1, then the next day was Sunday, June 11th, #2. >We arrived in LA 25 minutes before we stepped out of our >front door on the same day. I'll bet you didn't feel quite as rested as when you set out, though! <G> I remember flying back from Hong Kong a few years ago. I saw three sunrises that day. >So - good luck on Wednesday:-) ROFL!!! > In brief, my retinopathy seems to be receding quickly. The left eye > shows a great deal of improvement, as do many areas of my right. Excellent! > The bad news is that one of the edemas is worse, and will require > laser surgery. I'll be having it done on Tuesday. Not so good : ( But the laser surgery looks very effective. > This tells me, > loud and clear, that getting a newbie in for an exam is critical, > because in many cases once symptoms occur some irreversible damage has > likely been done. He most strongly recommends getting an exam within a > few weeks of DX. (So, yes, I'll be continuing to post my warnings to > newbies.) Sounds good to me. > I'm going to > ask my new GP (as soon as I find one) about reducing my metformin dose > so I don't need to snack to keep the between meal BG's up. That's not, of course, how it's supposed to work - unless your liver's being squashed very hard. I had a state-change happen about 5 months ago, and now I don't have liver dumps at all, either in the morning or if I'm not eating or have been exercising. Lovely job - I'm keeping my metformin levels right where they are! Nicky. SignatureA1c 10.5/5.4/<6 T2 DX 05/2004 1g Metformin, 100ug Thyroxine 95/74/72Kg >> In brief, my retinopathy seems to be receding quickly. The left eye >> shows a great deal of improvement, as do many areas of my right. [quoted text clipped - 24 lines] >or have been exercising. Lovely job - I'm keeping my metformin levels right >where they are! Hi Nicky! A state change? Hmmmmm!!! Mine has been gradual, but I've been seeing steady progress that sounds similar. I used to have small liver dumps (10 to 20 bg) and I still get gradual ones while hiking or jogging (bg's creep up to about 90, whether I eat or not). But, I've definitely noticed changes over time. The only reason I was going to ask about a Metformin reduction was it's the only drug I'm on, and if my Eye doc thinks I should keep my BG's where they are at for the time being, it was the only thing I could think of, to affect the between meal and fasting Bg's. I could reduce my Starlix consumption, but that would be tricky: I haven't taken any this year. :-) > The only reason I was going to ask about a Metformin reduction was > it's the only drug I'm on, and if my Eye doc thinks I should keep my [quoted text clipped - 3 lines] > I could reduce my Starlix consumption, but that would be tricky: I > haven't taken any this year. :-) Stop taking your Mum's pills then : ) I bet if you were seeing a cardiologist, he'd want you to stay on the met. Nicky. SignatureA1c 10.5/5.4/<6 T2 DX 05/2004 1g Metformin, 100ug Thyroxine 95/74/72Kg >> The only reason I was going to ask about a Metformin reduction was >> it's the only drug I'm on, and if my Eye doc thinks I should keep my [quoted text clipped - 5 lines] > >Stop taking your Mum's pills then : ) ROFL!! >I bet if you were seeing a cardiologist, he'd want you to stay on the met. Yep, and I have no intention of stopping the met. I was just considering lowering the dose slightly. (and only that after chatting with a Doc about it). > My current BG limits are under 120 at one hour, under 100 at two > hours, between 80 and 90 between meals. Without the fruit snacks I've > been having, my between meal bg's are in the low 70's. I'm going to > ask my new GP (as soon as I find one) about reducing my metformin dose > so I don't need to snack to keep the between meal BG's up. Chris, What are you eating????? If you are dropping into the 70s without insulin and need to eat fruit to bring your blood sugars up to 80-90, there's some question in my mind whether you are still "officially" diabetic. Though I was always told I had "mild diabetes" I was never able to get anywhere near the numbers you're posting with diet alone or with diet and metformin. Only wish insulin do I get close, but I'm still capable of missing the target. The question in my mind is this: is it possible that your diabetes really was a result of the massive infection combined with earlier weight gain and that by taking care of both you are back within normal limits? This wouldn't mean you are "cured". We all know that the diabetes would come back any time you got sloppy with the weight (or had another massive infection). But it might mean that you are, for the time being not diabetic, and that you might not have been diabetic before the infection, which would cast more light on the whole thing you've gone through this past year. --Jenny http://www.phlaunt.com/diabetes Diabetes Info http://www.alt-support-diabetes.org/newlydiagnosed.htm Get Your Blood Sugar Under Control > If you are dropping into the 70s without insulin and need to eat fruit > to bring your blood sugars up to 80-90, there's some question in my > mind whether you are still "officially" diabetic. I was dx'ed 5 years back. I take metformin now. I go upto 75 3-4 hours after any meal. If it's a low carb meal it may be earlier also (2.5-3 hours). And my one hour reading may be as high as 180-190, if I eat a high carb meal. > I was dx'ed 5 years back. I take metformin now. I go upto 75 > 3-4 hours after any meal. If it's a low carb meal it may be earlier > also (2.5-3 hours). And my one hour reading may be as high as > 180-190, if I eat a high carb meal. That sounds pretty typically diabetic, with a touch of reactive hypoglycemia, but Chris' posting makes it sound like he's also hitting his low one hour target and still dropping low, which is much more unusual since it shouldn't cause a reactive hypo. --Jenny http://www.phlaunt.com/diabetes Diabetes Info http://www.alt-support-diabetes.org/newlydiagnosed.htm Get Your Blood Sugar Under Control >> I was dx'ed 5 years back. I take metformin now. I go upto 75 >> 3-4 hours after any meal. If it's a low carb meal it may be earlier [quoted text clipped - 5 lines] > his low one hour target and still dropping low, which is much more > unusual since it shouldn't cause a reactive hypo. It could just mean his beta cells didn't take as big a pounding as other people's. I don't take meds at all and I often see numbers as low as Chris without it being an RH episode. >> My current BG limits are under 120 at one hour, under 100 at two >> hours, between 80 and 90 between meals. Without the fruit snacks I've [quoted text clipped - 5 lines] > >What are you eating????? For breakfast (I'm still very carb sensitive at breakfast) it's either salad or my mixed veg and ground flax, with a few dried tomatoes, plus blueberries and yoghurt as a side dish. This puts me up to about 115. Lunch, it varies a lot, as I hate repetition, but it's low saturated fat, low cholesterol, and low GI carbs (whole grain, or berries). About 40 cars average, and sends me to about 110. Dinner is much the same as lunch, same results. I eat very large amounts of highly colored veg, lots of herbs and spices, and make the fats healthy ones. I eat at least one large Avocado a day, plus, lately, a half pound of blueberries or similar dark berries (for eye benefits). I eat large amounts of spring onions (at least 8 a day)and mushrooms, etc. I no longer count calories, but my calorie consumption varies from about 2500 to about 3500, depending on activity levels (I'm very active, and the high calorie days would include walking/hiking over 10 miles). So far, my weight has remained stable within a two pound range. >>If you are dropping into the 70s without insulin and need to eat fruit >to bring your blood sugars up to 80-90, there's some question in my mind >whether you are still "officially" diabetic. I'm absolutely sure I'd be non diabetic, if I could give up eating entirely. :-) Seriously though, if I throw dietary control out the window, my BG's go through the roof. For example, the day I found out about my eye issues, I pigged out on regular lasagna (about 100 carbs worth). (Hunger, combined with major stress, makes me prone to do dumb things, diet-wise). I ended up in the 130's, getting off far easier than I deserved. That might not sound like much, but that's a 60 point spike, witch sounds very diabetic to me. 130's isn't bad, but the proof that I'm diabetic is what happened when I ate two gardenburger parties about a month ago. That was probably well under 30 carbs, but it sent me to almost 200! Also, a fairly low-carb cereal (also, like the gardenburgers, containing rice products) sent me to 160 in January. So, it seems that rice, or some component or product of it, makes my BG's go haywire, way out of proportion to carb content. I've seen other examples of this, too, so now I avoid rice and rice as an ingredient totally. Also, when I was on my trip in december, I decided to indulge in a buffet breakfast of pancakes, waffles, whipped cream with sugar in it (I didn't know about the sugar at the time), and some other nasties. I was thinking that my starlix (beta booster that I use on very rare occasions) would handle it. Due to an accident, my pills got swapped, and it turned out I hadn't taken my starlix. I ended up at 167, very diabetic. Also, my BG's went up by about 20 points (both PP and between meals) when I had a nasty cold in november. >Though I was always told I had "mild diabetes" I was never able to get >anywhere near the numbers you're posting with diet alone or with diet [quoted text clipped - 5 lines] >weight gain and that by taking care of both you are back within normal >limits? There are plenty of signs that I was diabetic for years, including a urine test (flight physical) showing sugar 20 years ago, when i was 19. I wasn't overweight then. Another possible indicator is headaches. I've had mild headaches ever since my early teens, perhaps once a week on average, though it varied (and stress would make me more prone to them). They were mild, and a couple of aspirin sent them away completely. However, since Dx, I've had none whatsoever. Not one headache. So, I suspect that the headaches might have been caused by high BG's, and if so indicate that I've been diabetic since my late teens. On the other hand, with the exception of rice, my carb tolerance has increased steadily since Dx. I expected it to cease improving once my weight loss ended, but it hasn't. Also, I'm on a fairly high dose (2000mg) of Metformin. I have no idea what I'd be like without it, but I suspect the Met is the reason for the vast majority of my BG improvement. It's the only drug I'm on. >This wouldn't mean you are "cured". We all know that the diabetes would >come back any time you got sloppy with the weight (or had another >massive infection). But it might mean that you are, for the time being >not diabetic, and that you might not have been diabetic before the >infection, which would cast more light on the whole thing you've gone >through this past year. I suspect the infection played a huge role. I do have hard evidence for this: My A1c at Dx was 12.5, but my fasting Bg's were over 600 on the labs. I'd had the infection for about three weeks at that point, but a fasting BG that high would cause an a1c far higher than 12.5 had I been at those levels for months or longer. However, I also suspect I've had high Bg's for many years, just not that high. BTW, I read your response to Just, and I wanted to clarify: I'm not having hypos, and this doesn't seem to be reactive hypoglycemia. My between meal Bgs just go down to the low 70's and stay there. This is fairly recent. They were in the 80's in January, 90's in November, etc. I don't feel any effects from being in the 70's, but this normoglycemic re-entry problem has made me wary of allowing my Bg average levels from going down further. So, I nibble on dried apricots (just one or two) to stay in the 80's. If I don't nibble, the Bg's stay put around 73 (meter variances ticks that up or down a few, but I suspect the actual Bg's are quite stable). I ended up in the 130's, getting off far easier than I > deserved. That might not sound like much, but that's a 60 point spike, > witch sounds very diabetic to me. It isn't. 130 after a meal is technically "normal" though an enlightened doctor would consider it something to watch to see if the person is developing impaired glucose tolerance. > > a fairly low-carb cereal (also, like the gardenburgers, containing rice > products) sent me to 160 in January. That would be "impaired glucose tolerance." Not diabetic. > Also, when I was on my trip in december, I decided to indulge in a > buffet breakfast of pancakes, waffles, whipped cream with sugar in it > (I didn't know about the sugar at the time), and some other nasties. <snip> I ended up at 167, very diabetic. Nope. Still only "impaired glucose tolerance" or pre-diabetes. Diabetic is over 200. If I ate the breakfast you describe I'd easily get up to 250 mg/dl. > Also, my BG's went up by about 20 points (both PP and between meals) > when I had a nasty cold in november. Everyone's will. This is part of the infection fighting strategy of the immune system. > Also, I'm on a fairly high dose (2000mg) of Metformin. I have no idea > what I'd be like without it, but I suspect the Met is the reason for > the vast majority of my BG improvement. It's the only drug I'm on. That might explain some of the improvement, but not all. For me, 1500 mg of metformin only lowers my postprandials about 20-30 mg/dl. My > between meal Bgs just go down to the low 70's and stay there. This is > fairly recent. They were in the 80's in January, 90's in November, > etc. Have you spoken to your doctor about cutting back a bit on your metformin? You're taking a lot and reducing it might keep you from seeing those 70s. --Jenny http://www.phlaunt.com/diabetes Diabetes Info http://www.alt-support-diabetes.org/newlydiagnosed.htm Get Your Blood Sugar Under Control > I ended up in the 130's, getting off far easier than I >> deserved. That might not sound like much, but that's a 60 point spike, >> witch sounds very diabetic to me. > >It isn't. 130 after a meal is technically "normal" Jenny, I'll have you know that no one has ever described me as normal. <g> Seriously though, I think it may have been "pizza effect". When I do spike, it's very brief, so anything that dulls the initial spike would probably keep me fairly low. I did note that my two hour and three hour Bg's were above normal, though not by a lot. >> a fairly low-carb cereal (also, like the gardenburgers, containing rice >> products) sent me to 160 in January. > >That would be "impaired glucose tolerance." Not diabetic. OK, let me ask a question. I'm just theorizing here, so it's a bit outlandish. Suppose, given my history of allergies, I turn out to be allergic to rice. Allergic reactions not only boost BG's, but cause inflammation. Is it theoretically possible that most of my long trouble (20 years of high BG's) could have been caused by rice? I did eat it fairly often. >> Also, when I was on my trip in december, I decided to indulge in a >> buffet breakfast of pancakes, waffles, whipped cream with sugar in it [quoted text clipped - 4 lines] >Nope. Still only "impaired glucose tolerance" or pre-diabetes. Diabetic >is over 200. >If I ate the breakfast you describe I'd easily get up to 250 mg/dl. My spike from that was very brief. By one hour PP I was well under 140. I'd have never caught the spike if I didn't test a lot. However, I still have at least one other downside to eating carbs: a large dose does make me hungry soon after, even if my BG's aren't an issue (In other words I get this without the typical steep drop in Bg's). That means that even if I could tolerate a high carb diet, my weight would soon return. > My >> between meal Bgs just go down to the low 70's and stay there. This is [quoted text clipped - 4 lines] >metformin? You're taking a lot and reducing it might keep you from >seeing those 70s. I'm going to do just that (speak to a doc about it), very soon. The other side of the coin is that what if it's insulin levels that are causal for my retinopathy problem? Decreasing the met will increase the insulin in my blood. So, too, does my nibbling. OK, this is another question for my specialist! > Suppose, given my history of allergies, I turn out to be allergic to > rice. Allergic reactions not only boost BG's, but cause inflammation. > Is it theoretically possible that most of my long trouble (20 years of > high BG's) could have been caused by rice? I did eat it fairly often. Looking at the huge improvement in Julie Bove's blood sugar now that she's eliminated things she's allergic to, this seems like a real possibility. Inflammation raises blood sugar, and if the allergy results in an inflammatory response, that might be part of the explanation. over 200. >> If I ate the breakfast you describe I'd easily get up to 250 mg/dl. > > My spike from that was very brief. By one hour PP I was well under > 140. I'd have never caught the spike if I didn't test a lot. Again, technically, the spike at 1/2 hour doesn't really count as that kind of spike from a very high carb meal is normal and does not correlate to organ damage. > However, I still have at least one other downside to eating carbs: a > large dose does make me hungry soon after, even if my BG's aren't an [quoted text clipped - 3 lines] > That means that even if I could tolerate a high carb diet, my weight > would soon return. True enough, and true for most "normal" people many of whom do have weight problems. > The other side of the coin is that what if it's insulin levels that > are causal for my retinopathy problem? There is no connection I've ever heard of between self-produced insulin and retinopathy. . There are tons of non-diabetic obese people who are highly insulin resistant but grow more beta cells in response to the demand for more insulin. They keep their blood sugars in the normal or near normal range as a result. They don't appear to develop retinopathy. It does seem to be the combination of very high blood sugar and then the lowering of that blood sugar (not necessarily to anything approaching normal levels) that is implicated. --Jenny http://www.phlaunt.com/diabetes Diabetes Info http://www.alt-support-diabetes.org/newlydiagnosed.htm Get Your Blood Sugar Under Control >> Suppose, given my history of allergies, I turn out to be allergic to >> rice. Allergic reactions not only boost BG's, but cause inflammation. [quoted text clipped - 5 lines] >possibility. Inflammation raises blood sugar, and if the allergy results >in an inflammatory response, that might be part of the explanation. Hmmmm... That sounds very interesting. I do recall that my one allergic reaction to seafood since Dx did result in some elevation in BG's for a few hours. One other thing comes to mind: you mentioned that in many normal people, beta cells are regrown/replaced. Could beta cell regeneration occur in a T2 *if* the initial pancreatic damage was caused by allergens, or was due to high IR caused by allergen inflammation? > One other thing comes to mind: you mentioned that in many normal > people, beta cells are regrown/replaced. Could beta cell regeneration > occur in a T2 *if* the initial pancreatic damage was caused by > allergens, or was due to high IR caused by allergen inflammation? Certainly. If you don't have the genetic flaw that causes your beta cells to die when they attempt to reproduce through cell division, you will end up growing back some beta cells. The best conduction study I've seen on this suggests that it is precisely this inability to grow new beta cells that separates the many obese, insulin resistant people who don't become diabetic from those who do. Remember, only a small percentage of obese, insulin resistant people become diabetic! There is also of course a separate age-related decline in beta cell activity that probably explains why a certain number of people in their 70s and older become diabetic as they age. Sorry to hear you are snowed in! --Jenny http://www.phlaunt.com/diabetes Diabetes Info http://www.alt-support-diabetes.org/newlydiagnosed.htm Get Your Blood Sugar Under Control >> One other thing comes to mind: you mentioned that in many normal >> people, beta cells are regrown/replaced. Could beta cell regeneration [quoted text clipped - 4 lines] >cells to die when they attempt to reproduce through cell division, you >will end up growing back some beta cells. The thing that got me thinking along these lines was the test showing sugar in my urine 20 years ago. If I was a normal T2, I'd have thought that would be too young to have T2 without being overweight, so I was wondering if it could be allergies or something else unusual. Regarding my Bg's, there is one big element of doubt: meter accuracy. My last lab was about 12 higher than my meter (I tested seconds after the lab draw). I have several meters, including three different brands, and they are all fairly consistent, but if they all under-read, then my BG's could well be really averaging 12 or more points higher than I've been reporting. I have another lab coming up soon, so I'll check again against the labs. However, my BG stability isn't what I thought it was. I just got a 123 45 minutes after a fairly low-carb (about 20) lunch, and it was a lunch that usually keeps me under 100. That's over a 40 point spike from 20 carbs, way outside my normal ratio. I also had to stop my snacking yesterday and really watch the carbs, as my Bgs were erratic and overly carb sensitive. Hmmm... I know a cold or flu can do this, but would fighting one off do the same? I was exposed to a cold on Saturday, and yesterday I had a sore throat for a few hours (my normal first sign with any respiratory virus). It went away, indicating that I've fought it off, and I feel ok today. OK, I just did a test before hitting send: exactly one hour after the first bite, I'm at 77 (15 minutes after the 123). BTW, Which of these should I consider my real PP peak? I might not be having my consultation and laser treatment tuesday after all. It may need to be delayed, because I neglected to check the weather reports Friday, and believed the local radio station when it said we were in for a "mild" storm. After having virtually no precip of any kind since October, my area got hit with a major blizzard. I was home at the time, and thought it was easing off Friday night. Instead, it snowed all night, and all day Saturday, and until Sunday morning. I am therefor snowed in. It's only about three foot deep, but it's drifted in places to six. So, I might be stuck for a while. I'm going to see about rescheduling, or I might try and cross-country ski out so I can make the appointment, but it all depends on how the weather is Monday morning. I need to ask the Doc about trying to ski out of here: it's very strenuous, and that as I understand it could make the edemas worse. Ugh.. What a catch 22. Oh well, I should know better than to make assumptions about the weather up here. >I might not be having my consultation and laser treatment tuesday > after all. It may need to be delayed, because I neglected to check the [quoted text clipped - 3 lines] > After having virtually no precip of any kind since October, my area > got hit with a major blizzard. Aaargh! Hope all goes well, whatever you decided - I guess if you've ski'd out, it might be a while before you can report back! Nicky. SignatureA1c 10.5/5.4/<6 T2 DX 05/2004 1g Metformin, 100ug Thyroxine 95/74/72Kg >>I might not be having my consultation and laser treatment tuesday >> after all. It may need to be delayed, because I neglected to check the [quoted text clipped - 6 lines] >Aaargh! Hope all goes well, whatever you decided - I guess if you've ski'd >out, it might be a while before you can report back! Yep! I'm going to try driving it, to get out of here anyway. I may well be offline for a few days, as I'll stay at my Mother's place in town. > Yep! I'm going to try driving it, to get out of here anyway. I may > well be offline for a few days, as I'll stay at my Mother's place in > town. I'll be sending good luck thoughts your way! Nicky. SignatureA1c 10.5/5.4/<6 T2 DX 05/2004 1g Metformin, 100ug Thyroxine 95/74/72Kg >> Yep! I'm going to try driving it, to get out of here anyway. I may >> well be offline for a few days, as I'll stay at my Mother's place in >> town. > >I'll be sending good luck thoughts your way! Thank you, Nicky!!! All went well. I've posted about it on another thread. : I might not be having my consultation and laser treatment tuesday : after all. It may need to be delayed, because I neglected to check the : weather reports Friday, and believed the local radio station when it : said we were in for a "mild" storm. : After having virtually no precip of any kind since October, my area : got hit with a major blizzard. I was home at the time, and thought it [quoted text clipped - 4 lines] : try and cross-country ski out so I can make the appointment, but it : all depends on how the weather is Monday morning. : I need to ask the Doc about trying to ski out of here: it's very : strenuous, and that as I understand it could make the edemas worse. : Ugh.. What a catch 22. Oh well, I should know better than to make : assumptions about the weather up here. Chris, Glad to hear that some water has arrived in your drought stricken area. sorry i is fouling up your reatment plans. I don't think tht sking to the apointment wudl be a great idea, as sking back woudl be far to active after that and your vision may well not be perfect for a while. Wendy >: I might not be having my consultation and laser treatment tuesday >: after all. It may need to be delayed, because I neglected to check the [quoted text clipped - 20 lines] >apointment wudl be a great idea, as sking back woudl be far to active >after that and your vision may well not be perfect for a while. I won't be skiing back. It would be mostly uphill, and would be about eight miles from the nearest cleared area. However, it's warm and sunny today, and the snow is melting fast. It's shallow enough that I can probably drive out without doing too much vehicle damage (And I'll take the skis just in case).It will be tricky, but I've done it before. I won't be driving after the surgery for a day, as I have no idea what the effect on my vision will be. I don't see why the eye they aren't treating would be affected, but they suggest I don't drive, so I won't. I'll drive to my Mother's house from here, and take a cab from there. I'll be staying there for at least a day after the surgery, so I'll be offline. I might be there longer unless the snow clears or there is more. This post not CC'd by email On Sat, 11 Mar 2006 21:10:13 -0700, Chris J. <chris@noadress.com> wrote: >OK, let me ask a question. I'm just theorizing here, so it's a bit >outlandish. [quoted text clipped - 3 lines] >Is it theoretically possible that most of my long trouble (20 years of >high BG's) could have been caused by rice? I did eat it fairly often. G'day G'day Chris, Rice is consider to be hypoallergenic ie unlikely to cause food intolerances or worse. Best wishes, SignatureQuentin Grady ^ ^ / New Zealand, >#,#< [ / \ /\ "... and the blind dog was leading." http://homepages.paradise.net.nz/quentin >This post not CC'd by email > [quoted text clipped - 10 lines] > Rice is consider to be hypoallergenic ie unlikely to cause food >intolerances or worse. Hmmmm??? When I fist suspected I might have trouble with rice, I did some looking, and found a few references. http://www.food-allergens.de/symposium-vol1(4)/data/rice/rice-abstract.htm http://www.food-allergens.de/symposium-vol1(4)/data/rice/rice-data.htm#Symptoms http://www.eatwell.gov.uk/healthissues/foodintolerance/foodintolerancetypes/rice allergy/ This does appear though to be more prevalent in people of Asian decent, which I am not. As far as I know, I'm of Caucasian decent. I'm by no means positive that I'm allergic to rice. The three reactions (high BG spikes only)that I'm basing this theory on all involved rice, but two were as a component along with other grains and substances (Gardenburgers, a vegetarian meat substitute, and a high fiber cereal that had some rice in it). The third case involved Spanish rice (typical at mexican restaurants) along with mexican food. So, it's quite possible that it's something else entirely. I'm beginning to think that I should get a full battery of allergy tests, just to be sure. Or, I could just eat a small portion of plain rice by itself, and see what my reaction is. What I dont understand Chris is why you would want to have lower than 5.0 bgs. That is an absolutely non diabetic number. I am glad you found out such good news. I hope the laser goes well, They are doing so much of it today, it is practically like brushing your teeth. Not that I kjnow anything about it, but I can say its nothing cause it is not me. lol good luck on Tuesday. I like this doctor, he had a long talk with you. how often can you say that about any doctor. Loretta -- In tribute to the United States of America and the State of Israel, two bastions of strength in a world filled with strife and terrorism. >What I dont understand Chris is why you would want to have lower than >5.0 bgs. That is an absolutely non diabetic number. [quoted text clipped - 8 lines] > >Loretta Hi, Loretta! Well, as for the Bg's, I thought 4.7 was a common target a1c? I guess I just assumed that lower is better, and I liked seeing the steady improvement. I'll be asking the retinal specialist about this, too. > had my second recent OCT scan and retinal exam today, plus a long > chat with the Ophthalmologist. Hi Chris, I just wanted to let you know that I am scheduled to have my super opthalmologist eye exam on Thursday, March 16, at 10:30 A.M. Thanks to you and Alan, I finally got motivated to have this done! I really do hate going to doctors, though.... all that fuss and muss... for what I suspect may be bad news in the end... But a man's gotta do what a man's gotta do.... (more muted drum beats, with bugles sounding a dirge in the distance) :-(0 Can't make the emoticon look like 'The Scream' by Edvard Munch, but you get the idea...... Maybe my world will start to look like that of Gustav Klimt...sometimes a little fuzzy, but always with great perspective! Sounds like a mixed bag for you, but probably more news than bad... In that light, I am happy that your long term prospects seem optimistic, although I would not want to have that lazer surgery! My Dad had it a few years ago, though, for detached retina, and it totally saved his vision in one eye... Thanks for keeping us posted. Hope you have a great weekend. :-) Will, T2 >> had my second recent OCT scan and retinal exam today, plus a long >> chat with the Ophthalmologist. [quoted text clipped - 4 lines] >opthalmologist eye exam on Thursday, March 16, at 10:30 A.M. Thanks to you >and Alan, I finally got motivated to have this done! I'm glad you are going, and please keep us posted on the results! > I really do hate going >to doctors, though.... all that fuss and muss... for what I suspect may be >bad news in the end... But a man's gotta do what a man's gotta do.... (more >muted drum beats, with bugles sounding a dirge in the distance) :-(0 ROFL! I sure sympathize! Before my Dx, I was a devout chicken when it came to things medical. I still am (I'm downright phobic) but this darn disease doesn't give us much choice in that area. Have a great weekend! : The bad news is that one of the edemas is worse, and will require : laser surgery. I'll be having it done on Tuesday. : However, all in all I'm very happy with the results. : Now, about my talk with the Ophthalmologist: He confirmed my belief : that my retinopathy is most likely transient (temporary). HOWEVER, he : does not believe that applies to the edemas they can cause. Those need : treating once past a certain point, as at least one of mine is. This is interesting, becuse I have had edemas tht have come and gone i my right eye, and thought that might have been the case wen I suddenly couldnt read the paper. I had had periods of no, or very low, edema over the previous 6-8 years. Mine, however, was probobly not caused by diabetes but the macular degenertion, although I have never herd of it beign a fluctuating condition and it ws not diagnosed until the newspaper reading emergency. Chris, I can't believe your numbers! they are incredible. Wendy >: The bad news is that one of the edemas is worse, and will require >: laser surgery. I'll be having it done on Tuesday. [quoted text clipped - 13 lines] >beign a fluctuating condition and it ws not diagnosed until the newspaper >reading emergency. One edema was worse, hence the laser appointment. The Doc was talking about edemas caused by normoglycemic re-entry, and did admit that there was very little data on this. Also, this was my ophthalmologist, not the retinal specialist. I'm having a consultation with him right before the laser treatment, so I'll know more after that. (I'll be asking him about this, and other issues). : In brief, my retinopathy seems to be receding quickly. The left eye : shows a great deal of improvement, as do many areas of my right. : The bad news is that one of the edemas is worse, and will require : laser surgery. I'll be having it done on Tuesday. : Now, about my talk with the Ophthalmologist: He confirmed my belief : that my retinopathy is most likely transient (temporary). HOWEVER, he : does not believe that applies to the edemas they can cause. Those need : treating once past a certain point, as at least one of mine is. Question here, woudl a steriod shot take down the edema permanently if the CAUSE of it has gone? My MD describes the steroid as pulling the plug ou of a bathtub. If noting is refilling it, woudl this work> I know it is a different technique (intraocular injection) that may well not be as widely available, but logically, it shudl work too. : As for what caused this (and thus important for newbies) he did : confirm that in his opinion, the rapid decrease in my BG's was causal. : HOWEVER, he feels that I'm "much better off in the long run". : He said the main danger is if a condition like mine was left untreated : UNTIL VISUAL PROBLEMS BECOME APPARENT. The reason is that once visual [quoted text clipped - 5 lines] : few weeks of DX. (So, yes, I'll be continuing to post my warnings to : newbies.) It looks , to me, tht our general advice to newbies is not only to go see a podiatrist, but see an opthamologist for a fully dilated exam ASAP, articularly if you are succeedign with your gaining control. (not Chris controm-just decent control:-) The opthamologist visit should be pushed hard. Perhaps a comment like, changes to your eyes can occur even befor diagnoses or early in your treatment, so a visit toan opthamologist is indicated ASAP to prevent any further damage. Mot a full scale scare, or a limit on trying to gain control, after all, how often does a Chris turn up, but a general warning and encouragement of a visit. Wendy >: In brief, my retinopathy seems to be receding quickly. The left eye >: shows a great deal of improvement, as do many areas of my right. [quoted text clipped - 12 lines] >different technique (intraocular injection) that may well not be as widely >available, but logically, it shudl work too. This is first on my list of questions for the specialist. If I need to cancel the laser, I'll certainly do so. >: He said the main danger is if a condition like mine was left untreated >: UNTIL VISUAL PROBLEMS BECOME APPARENT. The reason is that once visual [quoted text clipped - 15 lines] >a limit on trying to gain control, after all, how often does a Chris turn >up, but a general warning and encouragement of a visit. That's what I think, too. One thing though: obsessive I may be <g>, but the vast majority of my Bg decrease took place over just a few days on insulin, so had little to do with anything else. So, as insulin intervention seems implicated (by the general data, not just mine). : >It looks , to me, tht our general advice to newbies is not only to go see : >a podiatrist, but see an opthamologist for a fully dilated exam ASAP, [quoted text clipped - 5 lines] : >a limit on trying to gain control, after all, how often does a Chris turn : >up, but a general warning and encouragement of a visit. : That's what I think, too. : One thing though: obsessive I may be <g>, but the vast majority of my : Bg decrease took place over just a few days on insulin, so had little : to do with anything else. So, as insulin intervention seems implicated : (by the general data, not just mine). It went down so rapidly not only because of the insulin, but because of teh obsessive diet you created for yourself. Essentially you went about Atkins incuction (20 gr of carb) or lower with yru tofu and steamed vegetables. This is most unusual, even for people who have soem idea of the full range of carbs and adopt tje mp sigar-no white strches quick approach to strting to gain control Most also, even on insulin , with glucotxicity don't drop s fst as you did. Yu had the combo of all the antibiotics and a fairly rapid reductin in infection as wel as the insulin adn your self-created diet. As yu muct be aware from reading newbie posts here(and tey are motivated to come here) this rapid drop is very unusual. What none of us can know is what woudl have hapened had you had an eye exam within a onth of your diagnoses. That woudl be a uestion for both of our respective docs" How soon does this condition show up enough to be spotted in a regular dilated eye exam? There is no point in seeign the eye doc inthe first week-month-etc, if it won't be evident to a doc until , say 2 months, well before you noticed any problems. Wendy >: >It looks , to me, tht our general advice to newbies is not only to go see >: >a podiatrist, but see an opthamologist for a fully dilated exam ASAP, [quoted text clipped - 14 lines] >It went down so rapidly not only because of the insulin, but because of >teh obsessive diet you created for yourself. What? Me obsessive? <shocked look> > Essentially you went about >Atkins incuction (20 gr of carb) or lower with yru tofu and steamed [quoted text clipped - 5 lines] >adn your self-created diet. As yu muct be aware from reading newbie posts >here(and tey are motivated to come here) this rapid drop is very unusual. I know, I've seen plenty of other T2 reports on progress after Dx, and mine was indeed atypical. BTW, the antibiotics weren't working. The infection only began to clear up after my Bg's came down. (hence one of my reasons for being in a hurry). Also, there is a flip side to this: Insulin is indeed implicated. So, what if the amount of insulin is part of it? Had I eaten differently, I'd have used more insulin, probably a lot more. Ugh... Even with hindsight, I can't say what I should have done. >What none of us can know is what woudl have hapened had you had an eye >exam within a onth of your diagnoses. That woudl be a uestion for both of [quoted text clipped - 3 lines] >eye doc inthe first week-month-etc, if it won't be evident to a doc until >, say 2 months, well before you noticed any problems. That is a darn good point!!! I'll ask... Hi Chris: (snipped) > Also, there is a flip side to this: Insulin is indeed implicated. So, > what if the amount of insulin is part of it? Had I eaten differently, > I'd have used more insulin, probably a lot more. This is only speculative, based on the idea that you still have slightly impaired first phase insulin secretion and near normal second phase insulin secretion. This about what Jenny is suggesting when she mentions impaired glucose tolerance rather than frank T2 DM. It would take a glucose tolerance test to clear up this issue as well as the food allergy test such as potentially one for rice. I tend to view the glucose tolerance thing as a continuum. > Ugh... Even with hindsight, I can't say what I should have done. Not knowing any more than you did about your physiology, both you and the docs did the right thing. Frank >Hi Chris: >(snipped) [quoted text clipped - 9 lines] >allergy test such as potentially one for rice. I tend to view the >glucose tolerance thing as a continuum. I'm presently Endo-hunting, and will bring this up with them when I find one. I'd never imagined that I'd ever have to take a GTT... The idea of consuming that much glucose is not a pleasant one. Would there be any benefit to changing my Dx from DMT2 to IGT? I keep hearing that IGT should be "treated like full blown diabetes"? However, I'm wondering if the IGT would perhaps explain why Starlix is very effective with me. If I'm on starlix, I get a very smooth response, with a BG increase of less than 20 no matter what I eat. I've only used it for three meals, but the results were very consistent. Chris J.: > I'm presently Endo-hunting, and will bring this up with them when I > find one. [quoted text clipped - 4 lines] > Would there be any benefit to changing my Dx from DMT2 to IGT? I keep > hearing that IGT should be "treated like full blown diabetes"? What I am suggesting is a process of elimination. IGT or more normal glucose tolerance would indicate more beta-cells remaining. If I was IGT I would be more optumistic about a reversal of gene expressions and related proteins such as those that tie in with insulin synthesis on the one hand and others that relate to insulin resistances. Just my opinion. Frank >Chris J.: > [quoted text clipped - 9 lines] >What I am suggesting is a process of elimination. IGT or more normal >glucose tolerance would indicate more beta-cells remaining. Hmmmm... That would explain the HOMA calculation results, that I dismissed due to showing a too-high beta function (137%). > If I was >IGT I would be more optumistic about a reversal of gene expressions and >related proteins such as those that tie in with insulin synthesis on the >one hand and others that relate to insulin resistances. Just my opinion. That's a good point! Don't get me wrong, I certainly wouldn't object to finding out I was IGT, but I don't want to get my hopes up. I've heard many times (here in this group and elsewhere) that once you are T2, there is no going back. I've also heard many times that there is no such thing as a former diabetic. (with the exception of Gestational diabetes, and being male, I'm fairly sure that I have never had GD. :-) However, if what I had was in fact a misdiagnosis compounded by physiological factors (infection, allergies, etc) then perhaps it's not so impossible. : >Hi Chris: : >(snipped) [quoted text clipped - 9 lines] : >allergy test such as potentially one for rice. I tend to view the : >glucose tolerance thing as a continuum. : I'm presently Endo-hunting, and will bring this up with them when I : find one. : I'd never imagined that I'd ever have to take a GTT... The idea of : consuming that much glucose is not a pleasant one. : Would there be any benefit to changing my Dx from DMT2 to IGT? I keep : hearing that IGT should be "treated like full blown diabetes"? : However, I'm wondering if the IGT would perhaps explain why Starlix is : very effective with me. If I'm on starlix, I get a very smooth : response, with a BG increase of less than 20 no matter what I eat. : I've only used it for three meals, but the results were very : consistent. I can't comment on the starlix effect, but mine is much bunpier than yours. One important thing about not being diabetic is that your insurance is much cheaper adn easier to get (health insurance, that is). You may, however, not get insurance coverage for Starlix adn for test strips, which can be pricey. I can't see you really changeing your WOE now or your becoming any less vigilant about your numbers whatever they call it. that is just you, Chris. You will act fully to prevent your actually gettign diabetes if yu get the chance! Wow, what a thought! Wendy >: However, I'm wondering if the IGT would perhaps explain why Starlix is >: very effective with me. If I'm on starlix, I get a very smooth [quoted text clipped - 4 lines] >I can't comment on the starlix effect, but mine is much bunpier than >yours. How bumpy? >One important thing about not being diabetic is that your >insurance is much cheaper adn easier to get (health insurance, that is). What about the application question: "Have you ever been diagnosed with diabetes?" Usually a "yes", whatever the reason, makes for rejection, I thought? >You may, however, not get insurance coverage for Starlix adn for test >strips, which can be pricey. My present insurance only pays for the strips because the hospital stay took care of my yearly deductible. It's a weird policy in that it kicks in for all medical costs after a certain amount, no co-pays. However, in about three months I'm back to paying for test strips again. As for the starlix, it is pricy. But, I've had them since September, and have taken three pills. I still have 37 left. So, my current bottle should last a few more years. If the stuff will freeze, I'll get a refill before my insurance runs out. But, worst comes to worst, they run about $1 per pill (actually a bit less) online, so at my current consumption rate that's about 40 cents a month. I think I can handle it. :-) > I can't see you really changeing your WOE >now or your becoming any less vigilant about your numbers whatever they >call it. that is just you, Chris. You will act fully to prevent your >actually gettign diabetes if yu get the chance! Wow, what a thought! Whoa, this is all speculation at this point, so don't go kicking me out of our club just yet! (hey, what happened to the lifetime guarantee?) But, if it does end up that I have IGT, you are right, I won't change. I consider IGT to be just one step on the DM progression, so I'll keep on top of it with the same vigilance, as it's really the same thing. My main problem, either way, will be what I call "moving the goalposts". Not too many months ago, I considered Jennifer's guidelines to be unobtainable for me. Then, I started hitting them occasionally, then more often. So, what did I do? Move the goalposts! I set my PP goals as 130, not 140. So, what happened when I started getting those goals? I moved the goalposts again, of course, to 120! It's actually been very hard, psychologically, for me to try and keep my BG's where they are, instead of trying to improve them further. : >: However, I'm wondering if the IGT would perhaps explain why Starlix is : >: very effective with me. If I'm on starlix, I get a very smooth [quoted text clipped - 4 lines] : >I can't comment on the starlix effect, but mine is much bunpier than : >yours. : How bumpy? Not always predictable. of course, I don't take it frequently so don't have the kidn of long experience with it that woudl help me know. sometimes it works incredily well (at 60 at 2-3 hrs so I get to have my OJ:-) and sometimes it seems not to work until a kind of reverse pizza effect. High at 2 hours and crashing at 3, when i begin to feel funny so I test. : >One important thing about not being diabetic is that your : >insurance is much cheaper adn easier to get (health insurance, that is). : What about the application question: "Have you ever been diagnosed : with diabetes?" Usually a "yes", whatever the reason, makes for : rejection, I thought? Nor a clue. sounds like the es or no question " Have you stopped beatign your wife?" : >You may, however, not get insurance coverage for Starlix adn for test : >strips, which can be pricey. : My present insurance only pays for the strips because the hospital : stay took care of my yearly deductible. It's a weird policy in that it : kicks in for all medical costs after a certain amount, no co-pays. : However, in about three months I'm back to paying for test strips : again. : As for the starlix, it is pricy. But, I've had them since September, : and have taken three pills. I still have 37 left. So, my current : bottle should last a few more years. If the stuff will freeze, I'll : get a refill before my insurance runs out. : But, worst comes to worst, they run about $1 per pill (actually a bit : less) online, so at my current consumption rate that's about 40 cents : a month. I think I can handle it. :-) : > I can't see you really changeing your WOE : >now or your becoming any less vigilant about your numbers whatever they : >call it. that is just you, Chris. You will act fully to prevent your : >actually gettign diabetes if yu get the chance! Wow, what a thought! : Whoa, this is all speculation at this point, so don't go kicking me : out of our club just yet! (hey, what happened to the lifetime : guarantee?) No one is kickin you out. We have several no-yet's in the group and we woudl love to continue to have you as a "once was misdiagnosed." : But, if it does end up that I have IGT, you are right, I won't change. : I consider IGT to be just one step on the DM progression, so I'll keep : on top of it with the same vigilance, as it's really the same thing. Just a I thought:-) : My main problem, either way, will be what I call "moving the : goalposts". Not too many months ago, I considered Jennifer's : guidelines to be unobtainable for me. Then, I started hitting them : occasionally, then more often. So, what did I do? Move the goalposts! : I set my PP goals as 130, not 140. So, what happened when I started : getting those goals? I moved the goalposts again, of course, to 120! Yu really have to be careful ther, as you don't ant to be aiming for 0. We sould hate to have you constanly rushing to the hosital in an ambulance:-) Seriously, I think tht happens to many of us. I now, worry if I am at 120 at 2 hours, I like to be in teh 90's or very low 100'2 and try to figure what accounts for such a high number. Of course, that does not include last night. It is the Jewish Holiday of Purim when we eat little triangular pastries calle Hamantachen or Hamon's hat (or pockets). Well I bought some for my husband and they were out on the kitchen counter and my control fell. I tok a Starlix adn ate 4 right after dinner!!! at 1 1/2 hrs UI ws at 168 and at 2 hours 154. This morignI was back to 80, but never again!! I don't know, it just kind of happened adn today they are not tempting me. At the party we had after services all I had was 2 dried apricot halves, 1 dried fig and tow of the tiniest cookies I have ever sen! about 1/2-3/4" accross. Perfect for a diabetic's nibble:-) Lunch ws a big salad with some grilled chicken on it that ws to big, so dinner will be the same. : It's actually been very hard, psychologically, for me to try and keep : my BG's where they are, instead of trying to improve them further. At some point you have to say "this is stasis for me adn there is no need to struggle to go lower. Just like with weight loss you don't want to be a sugar anorexic-to coin a phrase. Wendy >: How bumpy? > [quoted text clipped - 4 lines] >effect. High at 2 hours and crashing at 3, when i begin to feel funny so >I test. I've never had a low from it. I find that even if I eat fewer carbs, it puts me in the 70's. One of the reasons I chose it (thanks to your recommendation) was it's declining effect as BG drops. I'm seriously considering thinking of a celebratory dinner since my Laser seems to have gone well. That might be carby, so I might have a Starlix (half a 120 mg pill), my first this year. I'll keep close track of the Bg's and post the results if I do. >: Whoa, this is all speculation at this point, so don't go kicking me >: out of our club just yet! (hey, what happened to the lifetime >: guarantee?) > >No one is kickin you out. I know.. I was just kidding... :-) Seriously though, I will look into this, and see where it leads. I'm not too hopeful though. I spoke to the Retinal specialist (who sees mostly diabetics, and is very knowledgable about DM in general) about the possibility of being misdiagnosed (we were discussing allergic issues, so it came up), and he said he didn't think so, as the DX criteria for DX were met, and the timeframe is too long to be considered transitory (and thus a misdiagnosis). His opinion will raise some hackles here: He said that *IF* I do end up passing a GTT, it would not invalidate my T2 Dx, it would merely make it no longer true. "in other words, you would be an official former diabetic". He did stress, though, that he is no Endo, so to take his words with a grain of salt. Think of the arguments I could get into here if I got THAT as an official Dx! <grin> >: My main problem, either way, will be what I call "moving the >: goalposts". Not too many months ago, I considered Jennifer's [quoted text clipped - 8 lines] >if I am at 120 at 2 hours, I like to be in teh 90's or very low 100'2 and >try to figure what accounts for such a high number. Think that's bad? Yesterday I got a 123 at 45 minutes PP, which quickly went down, and I fretted over that! >Of course, that does >not include last night. It is the Jewish Holiday of Purim when we eat [quoted text clipped - 3 lines] >1/2 hrs UI ws at 168 and at 2 hours 154. This morignI was back to 80, but >never again!! Yipes, and that's with a Starlix!?!? Remind me never to try those! >I don't know, it just kind of happened I know the feeling. I do things like that (only worse) when very stressed. When I got back from my first retinal exam last month, when I'd been Dx'd with retinopathy and macular edemas, plus was under the impression that I'd done it to myself, I was VERY stressed and depressed. So, I pigged out bigtime on lasagna. Wendy, I think we all have slips like that from time to time, it's part of being human, so don't be bummed out about what you did. > : It's actually been very hard, psychologically, for me to try and keep : >my BG's where they are, instead of trying to improve them further. > >At some point you have to say "this is stasis for me adn there is no need >to struggle to go lower. Just like with weight loss you don't want to be >a sugar anorexic-to coin a phrase. ROFL!! Well, I did manage it with weight loss. I did re-set my goal lower, but that's because I turned out to be about eight pounds fatter than I previously thought. Once I was happy with the body fat% and at a good lean condition, I did stop losing weight. I've gained ten pounds since, but the body fat % has dropped slightly, so it's not fat, and I'm ok with that, too. (in other words, it's weight, but it's muscle, so I'm not stressing over the increase in pounds). So, hopefully, I can find a BG comfort zone, too. Right now, I'm concentrating on keeping my current guidelines: FBG 70s, 1 hour PP less than 115, 2 hour under 85, and due to the ophthalmologist's advice I'm not trying to go any lower at all. >>One important thing about not being diabetic is that your >>insurance is much cheaper adn easier to get (health insurance, that is). > What about the application question: "Have you ever been diagnosed > with diabetes?" Usually a "yes", whatever the reason, makes for > rejection, I thought? These are questions of medical politics. When I showed my doc my BG graphs and asked for a GTT he pointed out that although there was no doubt about what the result would be, if he didn't officially test he couldn't officially diagnose me as a diabetic and therefore I wouldn't officially be a diabetic. Diabetics get free prescriptions, but since I was already old enough to qualify for free prescriptions (Scottish National Health Service), and was involved in negotiating various financial deals associated with my pension, it might well be advantageous to my financial health to be officially not diabetic. So as it happens, I'm officially not a diabetic, and get my strips prescribed free because I'm old enough to get all prescriptions free. And it did reduce the cost of my financial rearrangements. SignatureChris Malcolm cam@infirmatics.ed.ac.uk +44 (0)131 651 3445 DoD #205 IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK [http://www.dai.ed.ac.uk/homes/cam/] >>>One important thing about not being diabetic is that your >>>insurance is much cheaper adn easier to get (health insurance, that is). [quoted text clipped - 16 lines] >prescribed free because I'm old enough to get all prescriptions >free. And it did reduce the cost of my financial rearrangements. I am officially Dx'd, without a GTT, based on my very high BG's at DX. I don't know if the same would apply in the UK. I'm glad you made your system work for you. Sounds to me like you went into it with your eyes open and made the best choices. This post not CC'd by email On Thu, 09 Mar 2006 22:24:09 -0700, Chris J. <chris@noadress.com> wrote: >I had my second recent OCT scan and retinal exam today, plus a long >chat with the Ophthalmologist. [quoted text clipped - 6 lines] > >However, all in all I'm very happy with the results. G'day G'day Chris J, When I read this I'm glad we live in an age where such miracles are possible. Take a look at the scope of what you are saying. You were hit with a 1:50 bad chance result. Some of it is resolving itself. Some of it you have laser treatment available for. Even after being knocked brutally to the ground you are picking yourself up. Go man, go. >Now, about my talk with the Ophthalmologist: He confirmed my belief >that my retinopathy is most likely transient (temporary). HOWEVER, he >does not believe that applies to the edemas they can cause. Those need >treating once past a certain point, as at least one of mine is. Hey, I'm impressed. You aren't awfulizing. Instead you are making clear helpful distinctions. If there is one thing diabetes teaches us it is to face the facts calmly and deal with them. >As for what caused this (and thus important for newbies) he did >confirm that in his opinion, the rapid decrease in my BG's was causal. >HOWEVER, he feels that I'm "much better off in the long run". They say it is a sign of intelligence to be able to maintain two seemingly contrary thoughts without attempting to discount either of them. Keep this ophthalmologist on. You have to pick carefully whom you trust. I reckon you have a good one who will tell it straight. >He said the main danger is if a condition like mine was left untreated >UNTIL VISUAL PROBLEMS BECOME APPARENT. The reason is that once visual [quoted text clipped - 5 lines] >few weeks of DX. (So, yes, I'll be continuing to post my warnings to >newbies.) That could actually be a subtle pedal posterial percussive hint to haul their sorry a.ses down to an ophthalmologist sooner rather than later for a retinal exam. >Regarding blood sugars: > >He also said there are many schools of thought as to whether a slower >decline would lessen or avoid normoglycemic re-entry phenomenon. He >said he does not know the answer to that one. He's honest. Keep him. >I also asked him for specifics regarding HBA1C target levels. He said >under 6 is the ideal goal, as eye damage and degradation becomes far >more likly and severe as blood glucose levels increase. He also said >that there are recommendations out there that say 7% is ok, but he >said he doubted I'd find an ophthalmologist who thinks that. I like him, even though I've never met him. >OK, no major surprises so far, but here comes a doozy: >I asked him for target HB1AC's for me, personally. He remembered that [quoted text clipped - 5 lines] >couldn't hurt in my case, but he wouldn't advise anyone with higher >BG's to try that. Dried apricots!! Good on ya Chris. It puzzles me that people's short circuit logic leads them to discount dried fruit. I think it goes something like this. Dried fruit is full of sugar. Sugar is bad for T2 diabetics and besides they're not fresh so they lack Vit C. What this ignores is that they are rich in polyphenols that recycle vit C and they have a surprisingly steadying effect on blood glucose. I used to routinely eat one or two before driving. It was nutritional health insurance for me. >I asked about lowering my BG's further, (and here comes the shock) he >said he wouldn't advise it! At least not until my retinas are stable. >He also said he didn't see much point in even trying, even once I was >stable. My opinion is I'll leave things as they are for at least a >year, and see where things stand. That makes sense. You're in a low risk zone. Why shift out of it? >He didn't say so directly, but I think he was indicating that a BG >change right now (in either direction) could have a negative impact. Yeap. >My current BG limits are under 120 at one hour, under 100 at two >hours, between 80 and 90 between meals. Without the fruit snacks I've [quoted text clipped - 11 lines] >delights me, as I was very concerned that it's previous rapid >progression would continue. That I can understand. Long may you continue with the improvements. My guess is you are doing something right. Best wishes, SignatureQuentin Grady ^ ^ / New Zealand, >#,#< [ / \ /\ "... and the blind dog was leading." http://homepages.paradise.net.nz/quentin >This post not CC'd by email > [quoted text clipped - 17 lines] >knocked brutally to the ground you are picking yourself up. >Go man, go. This has admittedly been a bit of a worry for me, as vision loss has always been the DM complication that I fear most, but things are looking up. Even at worst, it looks as though one eye will be ok. So, I have a great deal to be thankful for. >>Now, about my talk with the Ophthalmologist: He confirmed my belief >>that my retinopathy is most likely transient (temporary). HOWEVER, he >>does not believe that applies to the edemas they can cause. Those need >>treating once past a certain point, as at least one of mine is. > >Hey, I'm impressed. You aren't awfulizing. I did a bit, mainly to myself, on day of the first retinal exam when I got the news. >>As for what caused this (and thus important for newbies) he did >>confirm that in his opinion, the rapid decrease in my BG's was causal. [quoted text clipped - 4 lines] >them. Keep this ophthalmologist on. You have to pick carefully whom >you trust. I reckon you have a good one who will tell it straight. I think very highly of him, especially as he's willing to admit when he does not know something. He even took the time to ask about, and page through with me, a dozen pages of studies I had with me. I didn't ask him to, he asked me. I liked him before, but now he'd have to work hard to drive me away. >>He said the main danger is if a condition like mine was left untreated >>UNTIL VISUAL PROBLEMS BECOME APPARENT. The reason is that once visual [quoted text clipped - 9 lines] >haul their sorry a.ses down to an ophthalmologist sooner rather than >later for a retinal exam. Precisely! <G> >>Regarding blood sugars: >> [quoted text clipped - 3 lines] > >He's honest. Keep him. My thoughts exactly. >>OK, no major surprises so far, but here comes a doozy: >>I asked him for target HB1AC's for me, personally. He remembered that [quoted text clipped - 10 lines] >something like this. Dried fruit is full of sugar. Sugar is bad for >T2 diabetics and besides they're not fresh so they lack Vit C. Those were my thoughts at Dx and for a while thereafter. I hated giving it up (Dried apricots and other fruits were a pre-Dx favorite), but I did so at Dx (I was highly glucotoxic, so I had to, for the short term). But, Guess who changed my thinking? YOU DID! So, I hesitantly, in tiny doses, tried dried apricots and other dried fruits while hiking. And, my BG's were fine. It took a few months, but I finally tried them while not hiking, and was fine then, too. So, THANK YOU! BTW, I also now eat a lot of blueberries and other fresh dark berries. >>I asked about lowering my BG's further, (and here comes the shock) he >>said he wouldn't advise it! At least not until my retinas are stable. [quoted text clipped - 3 lines] > >That makes sense. You're in a low risk zone. Why shift out of it? I'll be asking the retinal specialist for his advice on this, without mentioning to him the ophthalmologist's advice. It will be interesting to see what his take on it is. > I had my second recent OCT scan and retinal exam today, plus a long > chat with the Ophthalmologist. Dear Chris, All success on your treatment on Tuesday. Come monday, I will be heading to the hospital to make an appt with an opthamologist (thanks to Wendy and you). All the best to you Chris, San |
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